Work

Explainable machine learning model for predicting hearing recovery in unilateral sudden sensorineural hearing loss

Year: 2025

Type: article

Abstract: OBJECTIVE: Sudden Sensorineural Hearing Loss (SSNHL) is routinely encountered in otolaryngology clinics. The prognosis of SSNHL varies dramatically and depends on multiple influence factors. This study aimed to develop an explainable Machine Learning (ML) model with easily accessible features to predict the prognosis of SSNHL. METHODS: This bi-center retrospective study included 534 patients with SSNHL. We randomly split the data into training and validation sets. Univariate analysis and Least Absolute Shrinkage and Selection Operator (LASSO) regression were employed to select predominant features, including demographic, disease-specific characteristics, and laboratory items. We evaluated the performance of five ML models constructed with six crucial variables using the Area Under the receiver operating characteristic Curve (AUC), accuracy, specificity, sensitivity, and F1 scores. These models were further calibrated by calibration curve and Brier score. Clinical utility was evaluated by Decision Curve Analysis (DCA). The Shapley Additive Explanations (SHAP) method was applied to interpret feature contribution and explain the ML models. RESULTS: The Random Forest (RF) model reached the highest AUC of 0.998. Its accuracy, sensitivity, specificity, and F1 score were 0.981, 0.963, 0.989, and 0.967, respectively. DCA curve analysis revealed a comparable net benefit of the models. The SHAP method revealed that the primary features were degree of hearing loss, audiogram type, age, Mean Corpuscular Volume (MCV), onset to treatment, and serum Albumin (ALB) accordingly. CONCLUSIONS: The explainable ML model was superb in predicting hearing outcome and providing information on feature contributions. Clinicians can better understand the contributors to hearing recovery and guide aural rehabilitation using the SHAP method. LEVEL OF EVIDENCE: Level 3.

Source: Brazilian Journal of Otorhinolaryngology

DOI: 10.1016/j.bjorl.2025.101730